Podcast Link: SGEM189 Date: September 19th, 2017 Reference: Cournoyer et al. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. September 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the AAEM MedEdPORTAL. Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. Background: There are about ½ million sudden cardiac arrests in the USA each year. About half of these cardiac arrests are OHCA and the survival rate is pretty poor. We have covered the topic of OHCA on the SGEM...

Podcast Link: SGEM184 Date: June 21st, 2017 Reference: Konstantinides et al. Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did her Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Kirsty is also the creator of a knowledge translation project called #PaperinaPic. Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. She is alert and talking, with a systolic blood pressure of 110 mmHg, but CTPA...

Podcast Link: SGEM183 Date: June 20th, 2017 Reference: Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Guest Skeptic: Jay Loosley is a Registered Nurse, and an Advanced Care Paramedic in London. His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. Case: A 71-year-old woman has a witnessed arrest while watching her granddaughter’s soccer game. By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation. She is not in a shockable rhythm. They continue CPR, get intravenous access, give a round of epinephrine and then wonder if they should start rapid cooling en-route to the hospital...

Podcast Link: SGEM176 Date: April 26th, 2017 Reference: Syed et al. Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring. CMAJ Jan 2017 Guest Skeptics: Drs. Ryan Tam and Antony Robert are chief residents from the Royal College Emergency Medicine Program at McGill University. Ryan Tam’s academic interests include quality improvement, ultrasound and simulation. He is also involved with a start-up FOAMed site called EM-bites focused on providing point of care resources. When he is not working, he is an enthusiastic photographer, foodie and adventure traveler. Antony Robert’s academic interests include resuscitation, medical education, research, ultrasound and medical informatics. He is also the CEO of a new medical education start up, and is currently working on the first prototype. When he is not working, he...

Podcast Link: SGEM170 Date: March 2nd, 2017 Reference: Stiell et al. Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. AEM March 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the author of the excellent #FOAMed blog called First10EM.com and is an associate editor of Emergency Medicine Cases. Case: A 68-year-old woman with a history of congestive heart failure, hypertension, and hyperlipidemia presents to the emergency department with a three-day history of shortness of breath on exertion, orthopnea and mild leg edema, but with normal vital signs. Her renal function is normal and troponin is negative. Her ECG is normal. After a dose of intravenous furosemide, she says she feels a lot better and would...

Podcast Link: SGEM163 Date: October 6th, 2016 Reference: Piazza et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism. JACC 2015 Guest Skeptic: Dr. Essie Reed is one of the Chief Residents in the Department of Emergency Medicine at the University of Buffalo. Case: A 75-year-old female with a past medical history of hypertension and non-insulin dependent diabetes presents with chest pain. She describes the pain as sharp, stabbing, and exacerbated with deep inspiration. She reports associated shortness of breath. She denies syncope, nausea, and diaphoresis. The pain has been present for one week, and is nearly constant. She reports that she traveled to Florida to visit her grandchildren three weeks ago. She has no fever, chills, cough, or sputum production. She is complaining of ongoing chest pain, 5/10, increased to 7/10 when asked...